Controversies in Orthognathic Surgery

Controversy has accompanied orthognathic surgery since its adaptation for the correction of dentofacial deformities. With the development of less invasive and less morbid osteotomy designs, questions regarding overall osteotomy stability have abounded. The transition from prolonged intermaxillary fixation and wire osteosynthesis to rigid internal fixation has spurred questions regarding the most effective fixation technique, and challenged previously accepted hierarchies of stability. These questions represent only the surface of a sea of debate and discussion, as measures have been taken to optimize patient outcome, minimize patient morbidity, and maximize operating room productivity.